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Valve replacement in africa

Emmanuel K Rusingiza, Ziad El-Khatib, Bethany Hedt-Gauthier, Gedeon Ngoga, Symaque Dusabeyezu, Neo Tapela, Cadet Mutumbira, Francis Mutabazi, Emmanuel Harelimana, Joseph Mucumbitsi, Gene F Kwan, Gene Bukhman
BACKGROUND: In sub-Saharan Africa, continued clinical follow-up, after cardiac surgery, is only available at urban referral centres. We implemented a decentralised, integrated care model to provide longitudinal care for patients with advanced rheumatic heart disease (RHD) at district hospitals in rural Rwanda before and after heart surgery. METHODS: We collected data from charts at non-communicable disease (NCD) clinics at three rural district hospitals in Rwanda to describe the outcomes of 54 patients with RHD who received cardiac valve surgery during 2007-2015...
April 20, 2018: Heart: Official Journal of the British Cardiac Society
Riccardo Asteggiano, Peter Bramlage, Dimitrios J Richter
Background Transcatheter aortic valve implantation (TAVI) continues to gain popularity in the management of patients with severe aortic stenosis (SAS). Distribution of resources to maximise appropriate use remains a priority. Design & methods To determine the current perceptions and behaviours regarding SAS patient management, an 18-point multiple-choice questionnaire was distributed to European Society of Cardiology (ESC) Council for Cardiology Practice (CCP) e-journal and/or electronic newsletter subscribers...
April 2018: European Journal of Preventive Cardiology
África Duque Santos, Andrés Reyes Valdivia, Pablo Gallo González, Eduardo González Ferrer, Julia Ocaña Guaita, Claudio Gandarias Zúñiga
BACKGROUND: To report a case of rupture of the descending aorta after aortic migration during transcatheter aortic valve replacement (TAVR). METHODS: An 85-year-old man with a severe and symptomatic aortic stenosis underwent elective TAVR, which complicated with embolization into the ascending aorta. While repositioning into the descending aorta, the procedure complicated with aortic rupture. RESULTS: The patient required urgent thoracic intravalve stent-graft implantation (thoracic endovascular aortic repair [TEVAR])...
May 2018: Annals of Vascular Surgery
Trust Saidi, Tania S Douglas
The treatment of rheumatic heart disease presents a medical and surgical challenge, particularly in developing countries, where the disease is prevalent. Most of these countries find it prohibitively expensive to import heart valve prostheses that are required for treatment and are largely manufactured in the United States and Europe. Even if the valves were available, the absence of facilities to conduct open-heart surgery for valve replacement results in many people from developing countries dying needlessly of the disease...
October 2016: Expert Review of Medical Devices
Antonio Grimaldi, Ana Olga Mocumbi, Juergen Freers, Matthias Lachaud, Mariana Mirabel, Beatriz Ferreira, Kumar Narayanan, David S Celermajer, Daniel Sidi, Xavier Jouven, Eloi Marijon
Tropical endomyocardial fibrosis (EMF) is a neglected disease of poverty that afflicts rural populations in tropical low-income countries, with some certain high-prevalence areas. Tropical EMF is characterized by the deposition of fibrous tissue in the endomyocardium, leading to restrictive physiology. Since the first descriptions in Uganda in 1948, high-frequency areas for EMF have included Africa, Asia, and South America. Although there is no clear consensus on a unified hypothesis, it seems likely that dietary, environmental, and infectious factors may combine in a susceptible individual to give rise to an inflammatory process leading to endomyocardial damage and scar formation...
June 14, 2016: Circulation
Samuel Kingué, Serigne Abdou Ba, Dhadi Balde, Mamadou Bocary Diarra, Jean-Baptiste Anzouan-Kacou, Benedict Anisubia, Jean-Marie Damorou, Pierre Ndobo, Alain Menanga, Abdoul Kane, Maurice Kakou-Guikahué, Monique Kenfack, Bernard Metogo, David Chelo, Euloge Yangnigni, Cabral Tantchou, Edmond Bertrand, Jean-Jacques Monsuez
BACKGROUND: There are few African data available on rheumatic heart disease (RHD). AIM: To provide data on the clinical characteristics and treatment of patients with RHD hospitalized in sub-Saharan Africa. METHODS: The VALVAFRIC study is a multicentre hospital-based retrospective registry of patients with RHD hospitalized in African cardiology departments from 2004 to 2008. RESULTS: Among 3441 patients with at least one mild RHD lesion seen on echocardiography in 5 years in 12 cardiology departments from seven countries, 1385 had severe lesions (502 men; 803 women; mean age 29...
May 2016: Archives of Cardiovascular Diseases
E L Benade, B F Jacobson, S Louw, E Schapkaitz
BACKGROUND: Measurement of the international normalised ratio (INR) is essential in the management of patients on long-term warfarin therapy. The CoaguChek XS portable coagulometer is a point-of-care test for INR measurement. It offers the advantage of improved patient accessibility, particularly in peripheral clinics. OBJECTIVES: To evaluate the clinical utility of the CoaguChek XS for monitoring of patients on standard warfarin therapy (INR 2 - 3) as well as those with mechanical heart valve replacements (INR 2...
March 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Francesco Arioli, Paul G D'Arbela, Francesco Aloi, Martin M Nsubuga, Antonio Grimaldi, Enrico Ammirati
No abstract text is available yet for this article.
October 20, 2014: International Journal of Cardiology
Thomas A Mabin, Pascal Condolfi
OBJECTIVE: Transcatheter aortic valve implantation (TAVI) has become the standard of care for inoperable patients with severe aortic stenosis and is an alternative to conventional surgery for high-risk aortic valve replacement (AVR) patients. There is a positive correlation between severity of pre-operative patients and hospital costs. The aim of this study was to compare empirically derived costs of the two therapies in South Africa. METHODS: The cost-comparison analysis was performed with a MediClinic database including 239 conventional isolated AVR (cAVR) and 75 TAVI cases...
January 2014: Cardiovascular Journal of Africa
Adanze O Asinobi, Adebowale D Ademola, Oluwatoyin O Ogunkunle, Susan A Mott
BACKGROUND: Children and adolescents with end-stage renal disease (ESRD) in sub-Saharan Africa may have the worst outcomes globally. Barriers to management include late presentation, poor socioeconomic conditions, absence of medical insurance, limited diagnostic facilities and non-availability of chronic renal replacement therapy (RRT). Our study was to determine the incidence, aetiology, management and outcomes of paediatric ESRD in a tertiary hospital in Nigeria. METHODS: A retrospective case review of paediatric ESRD at the University College Hospital Ibadan, Nigeria, over 8 years, from January 2005 to December 2012...
February 3, 2014: BMC Nephrology
Jacques Cabral Tantchou Tchoumi, Gianfranco Butera
BACKGROUND: Cardiovascular diseases (CVD) have emerged as a major public health problem and impose an escalating burden on the health care system in Cameroon. The aim of the study was to investigate the preparedness of health care services for patients presenting with CVD in general and specifically, in St. Elizabeth catholic general hospital Shisong, cardiac centre. PATIENTS AND METHODS: Between November 2009 and November 2011, a population of 8,389 adults and 706 children consulted the referral cardiac centre of St...
December 2013: Cardiovascular Diagnosis and Therapy
Yves d'Udekem, Varun Sharma
This article outlines the arguments against cusp extension, which were put forward at the debate entitled "Repair options in rheumatic aortic disease in young patients" at the Symposium on Surgery for Rheumatic Heart Disease organized by The World Society for Pediatric and Congenital Heart Surgery at The Sixth World Congress of Paediatric Cardiology and Cardiac Surgery, February 17-22, 2013, Cape Town, South Africa. We propose that cusp extension should be avoided because (1) these patients are usually old enough to receive the same valve substitutes as adults, (2) lack of antibioprophylaxis compliance will likely result in early reintervention, (3) cusp extension mandates rerepair within four to five years and is more expensive in the long term, and (4) it is fraught with myocardial ischemic complications...
October 2013: World Journal for Pediatric & Congenital Heart Surgery
B Mazibuko, H Ramnarain, J Moodley
BACKGROUND: Cardiac disease in pregnancy is a common problem in under-resourced countries and a significant cause of maternal morbidity and mortality. A large proportion of patients with cardiac disease have prosthetic mechanical heart valve replacements, warranting prophylactic anticoagulation. AIM: To evaluate obstetric outcomes in women with prosthetic heart valves in an under-resourced country. METHODS: A retrospective chart review was performed of 61 pregnant patients with prosthetic valve prostheses referred to our tertiary hospital over a five-year period...
May 2012: Cardiovascular Journal of Africa
Maboury Diao, Adama Kane, Mouhamadou Bamba Ndiaye, Alassane Mbaye, Malick Bodian, Mouhamadoul Mounir Dia, Moustapha Sarr, Abdoul Kane, Jean-Jacques Monsuez, Serigne Abdou Ba
BACKGROUND: Although previous studies showed that pregnancy with heart disease is associated with significant complications, few focused on patients with valvular heart disease in sub-Saharan Africa. METHODS: We report maternal and foetal outcomes in 50 pregnant women with heart disease admitted to the Department of Cardiology of the University of Dakar, during an 8-year period. RESULTS: Rheumatic heart disease was observed in 46 women, seven of whom had previously been operated on...
June 2011: Archives of Cardiovascular Diseases
Frank Edwin, Ernest Aniteye, Mark Mawutor Tettey, Martin Tamatey, Kwabena Frimpong-Boateng
BACKGROUND: The West African sub-region has poor health infrastructure. Mechanical valve replacement in children from such regions raises important postoperative concerns; among these, valve-related morbidity and complications of lifelong anticoagulation are foremost. Little is known about the long-term outcome of mechanical valve replacement in West Africa. We sought to determine the outcome of mechanical valve replacement of the left heart in children from this sub-region. METHOD: We conducted a retrospective review of all consecutive left heart valve replacements in children (< 18 years old) from January 1993 - December 2008...
2011: Journal of Cardiothoracic Surgery
M O Odubanjo, A O Oluwasola, S Kadiri
The incidence of CKD (Chronic kidney disease) in Nigeria has been shown by various studies to range between 1.6 and 12.4%. We have shown that the burden of renal disease in Nigeria is probably significantly higher than any previous study on end-stage renal disease (ESRD) has documented, as most studies are hospital-based and fail to include the many patients who do not have access to hospital care. The increased prevalence of ESRD among blacks in the United States and South Africa compared with other races also suggests that ESRD may be more prevalent in Africa than in the United States and other developed nations...
September 2011: International Urology and Nephrology
Lezelle Botes, Johannes Jacobus van den Heever, Francis Edwin Smit, William Morris Leonard Neethling
The history of using homologous cardiac valves dates back more than 30 years. Through the years emphasis was placed on the optimization of graft retrieval, preservation techniques and clinical application. A cardiac homograft valve bank was established at the Department of Cardiothoracic Surgery, University of the Free State, Bloemfontein in 1982. A retrospective analysis was performed on all allograft data since 1984. Since the first valve was successfully procured and transplanted in 1984, 2,540 aortic and pulmonary homografts were harvested from 1,792 donors, of which 1,545 [989 (64%) aortic and 556 (36%) pulmonary] were released for clinical use...
March 2012: Cell and Tissue Banking
Layla Rifai, Nadjib Hammoudi, Pierre Fouret, Christophe Acar
Right-sided forms account for one-fourth of endomyocardial fibrosis cases in central Africa. A 50-year-old female patient with endo- myocardial fibrosis presented with unusual calcifications of the right ventricular endocardium that embedded the tricuspid valve papillary muscles. Bioprosthetic tricuspid valve replacement together with right ventricular endocardectomy was performed with a good clinical outcome.
March 2011: Interactive Cardiovascular and Thoracic Surgery
Karen Sliwa, Melinda Carrington, Bongani M Mayosi, Elias Zigiriadis, Robert Mvungi, Simon Stewart
AIMS: Little is known on the incidence and clinical characteristics of newly diagnosed rheumatic heart disease (RHD) in adulthood from urban African communities in epidemiologic transition. METHODS AND RESULTS: Chris Hani Baragwanath Hospital services the black African community of 1.1 million people in Soweto, South Africa. A prospective, clinical registry captured data from all de novo cases of structural and functional valvular heart disease (VHD) presenting to the Cardiology Unit during 2006/07...
March 2010: European Heart Journal
T Nqayana, J Moodley, D P Naidoo
This study was a retrospective review of patient charts of a relatively large number of patients with cardiac disease in pregnancy in a developing country. Ninety-five patients were evaluated; the majority (n = 36) were in the age group 21-25 years. Rheumatic heart disease was the commonest aetiology; eight women required balloon mitral valvuloplasty and one had a valve replacement at 32 weeks' gestation. There were no maternal deaths but morbidity was high; 13 patients were admitted in cardiac failure, nine had atrial fibrillation and three required intensive-care management...
May 2008: Cardiovascular Journal of Africa
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